Anesthesia and analgesia
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Anesthesia and analgesia · Sep 2014
Randomized Controlled Trial Multicenter StudyPerioperative Goal-Directed Hemodynamic Optimization Using Noninvasive Cardiac Output Monitoring in Major Abdominal Surgery: A Prospective, Randomized, Multicenter, Pragmatic Trial: POEMAS Study (PeriOperative goal-directed thErapy in Major Abdominal Surgery).
Goal directed fluid and vasoactive therapy using a non-invasive cardiac output monitor does not reduce complications after major abdominal surgery.
pearl -
Anesthesia and analgesia · Sep 2014
Randomized Controlled TrialUltrasound-Guided Pulsed Radiofrequency Stimulation of the Suprascapular Nerve for Adhesive Capsulitis: A Prospective, Randomized, Controlled Trial.
Pulsed radiofrequency stimulation of the suprascapular nerve improves pain and range of motion in those with adhesive capsulitis.
pearl -
Anesthesia and analgesia · Sep 2014
Multicenter StudyClinical Evaluation of a Novel System for Monitoring Surgical Hemoglobin Loss.
Accurate measurement of intraoperative blood loss is an important clinical variable in managing fluid resuscitation and avoiding unnecessary transfusion of blood products. In this study, blood lost onto laparotomy sponges during surgical cases was measured using a tablet computer programmed with a unique algorithm modeled after facial recognition technology. In this study, we assessed the accuracy and performance of the system in surgical cases. ⋯ The novel mobile monitoring system provides an accurate measurement of Hb mass on surgical sponges as compared with that of manual rinsing measurements and is significantly more accurate than the gravimetric method. Further study is warranted to assess the clinical use of the technology.
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Diagnosis of sepsis in the postoperative period is a challenge. Measurements of inflammatory markers, such as C-reactive protein (CRP), have been proposed in medical patients, but the interpretation of these values in surgical patients is more difficult. We evaluated the changes in blood CRP levels and white blood cell count in postoperative patients with and without infection. ⋯ CRP levels increase in the first week after major surgery but to a much larger extent in infected than in noninfected patients. Persistently high CRP levels after POD 4, especially when >100 mg/L, suggest the presence of a postoperative infection.